Doctor Name: | DR. LARRY L HEDGEPATH |
NPI Number: | 1366465163 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 30039 |
Business Practice Address: | 374 Hudlow Rd Forest City, NC - 280439444 |
Business Phone Number: | 8282450095 |
Business Fax Number: | 8282481035 |
Mailing Address: | 374 Hudlow Rd, FOREST CITY |
State: | NC |
Postal Code: | 280439444 |
Phone Number: | 8282450095 |
Fax Number: | 8282481035 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 30039 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |